Safe pregnancy after liver transplantation: Evidence from a multicenter Italian collaborative study. Issue 5 (May 2022)

• Record Type: Journal Article
• Authors: Sciarrone, Salvatore Stefano; Ferrarese, Alberto; Bizzaro, Debora; Volpato, Sofia; Donato, Francesca Maria; Invernizzi, Federica; Trespidi, Laura; Ramezzana, Ilaria Giuditta; Avolio, Alfonso Wolfango; Nure, Erida; Pascale, Marco Maria; Fagiuoli, Stefano; Pasulo, Luisa; Merli, Manuela; Lapenna, Lucia; Toniutto, Pierluigi; Lenci, Ilaria; Di Donato, Roberto; De Maria, Nicola; Villa, Erica; Galeota Lanza, Alfonso; Marenco, Simona; Bhoori, Sherrie; Mameli, Laura; Cillo, Umberto; Boccagni, Patrizia; Russo, Francesco Paolo; Bo, Patrizio; Cosmi, Erich; Burra, Patrizia
• Is Part Of: Digestive and liver disease. Volume 54:Issue 5(2022)
• Page Start: 669
• Page End: 675
• Publication Date: 2022-05
• Subjects: Pregnancy outcomes -- Liver transplantation -- Infertility -- Immunosuppression; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.08.013
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Women who have undergone liver transplantation (LT) enjoy better health, and possibility of childbearing. However, maternal and graft risks, optimal immunosuppression, and fetal outcome is still to clarify. Aim: Aim of the study was to assess outcomes of pregnancy after LT at national level. Methods: In 2019, under the auspices of the Permanent Transplant Committee of the Italian Association for the Study of the Liver, a multicenter survey including 14 Italian LT-centers was conducted aiming at evaluating the outcomes of recipients and newborns, and graft injury/function parameters during pregnancy in LT-recipients. Results: Sixty-two pregnancies occurred in 60 LT-recipients between 1990 and 2018. Median age at the time of pregnancy was 31-years and median time from transplantation to conception was 8-years. During pregnancy, 4 recipients experienced maternal complications with hospital admission. Live-birth-rate was 100%. Prematurity occurred in 25/62 newborns, and 8/62 newborns had low-birth-weight. Cyclosporine was used in 16 and Tacrolimus in 37 pregnancies, with no different maternal or newborn outcomes. Low-birth-weight was correlated to high values of AST, ALT and GGT. Conclusion: Pregnancy after LT has good outcome; however, maternal complications and prematurity may occur. Compliance with the immunosuppression is fundamental to ensure the stability of graft function and prevent graft-deterioration.